Department of Health behind the eight ball

By Su Wei-shuo 蘇偉碩

The quality of hospitals' control of "hospital transmission" of SARS is self-evident in light of the deaths of several medical workers after attending SARS patients.

Data on this epidemic prove that SARS is mostly spread within hospitals or households. Therefore, to stop the disease from spreading further, we have to make sure that medical institutions can screen SARS patients in a timely manner, quarantine them, treat them and completely stop hospital transmissions from happening.

Unfortunately, in the Department of Health's report to the Legislative Yuan -- submitted on May 12, International Nurse's Day -- the first priority was detection and reduction of SARS patients from overseas, and the prevention of hospital transmissions was listed as the last priority. Today, probable SARS cases reported from Taipei Municipal Hoping Hospital, Jen Chi Hospital and Taipei Municipal Chung Hsing Hospital account for almost 60 percent of the total probable cases here.

However, the department is still unable to analyze its short-comings and raise the prevention level of all medical institutions to the maximum in order to accom-plish Premier Yu Shyi-kun's goal of ending hospital transmissions.

No surprise, the idea that "SARS prevention is a war" is merely a slogan for the department. Health authorities' ignorance of the urgency of hospital-transmission control will also become the biggest problem in the nation's SARS prevention.

When SARS patients first fall ill, most of them only have a high fever and may not necessarily have other symptoms. If the department only requires those SARS-specialized hospitals appointed by the Cabinet to launch a third-degree prevention system, isn't it assuming that every patient is fully capable of telling whether he or she has SARS, and that everyone is 100 percent sure about which hospital is a SARS-specialized hospital? Who will take the responsibility when hospital transmission is caused by a SARS patient who is not clear about his or her own illness and consults a doctor at a regular hospital?

Another major mistake is that, after hospital transmissions occurred at several large hospitals, the department still passed the supervision of hospital transmission to the local governments which are incapable of the task. The last of the department's SARS prevention measures clearly states that it's necessary to strengthen the prevention of group transmissions in hospitals.

But the content of the measure in fact only requires hospitals to set up isolation wards in proportion to the numbers of their beds and provides the principles for handling a probable transmission inside hospitals. But the department has no policy on how to truly strengthen the prevention of SARS transmissions in hospitals at all.

Such misconduct by top health officials is a violation of the Communicable Disease Prevention Law (傳染病防治法). The department has completely neglected its duty as the nation's highest health agency and ignored the lives and health of the people.

Therefore, to prevent hospital transmissions from taking more lives, the Cabinet should inform each and every medical center to launch a third-degree prevention system right away.

The department should certainly make the prevention of hospital transmissions a priority. It should come up with a standard operating procedure for receiving and treating SARS patients, and provide medical workers with sufficient prevention facilities and equipment. Taiwan will be unable to bear the consequences if the kind of massive SARS outbreak that occurred at Hoping Hospital occurs at another hospital.